Correlation between bispectral index monitor and subjective scale in assessing the depth of sedation of mechanically ventilated patients: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

WANG Zhuheng ¹ , CHEN Han ² ,  ZHOU Jianxin ²

1. Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, 102600, P.R.China;
2. Department of Critical Care Medicine, Daxing Teaching Hospital, Capital Medical University, Beijing, 100050, P.R.China;

Corresponding?author：

ZHOU Jianxin, Email: zhoujx.cn@icloud.com

Keywords：

Bispectral index; Mechanically ventilate; Sedation; Richmond agitation sedation scale; Sedation-agitation scale; Meta-analysis

DOI：

10.7507/1672-2531.201609013

Video：

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Objective To assess the correlation between bispectral index (BIS) and richmond agitation sedation scale (RASS) and sedation-agitation scale (SAS) through the spearman correlation coefficient by systematic review. Methods Databases including PubMed, EMbase, Web of Science, The Cochrane Library (Issue 7, 2016), CNKI, VIP, WanFang Data and CBM were searched from inception to July 2016 to collect literature on the correlation between BIS and RASS and SAS. The studies were screened according to the inclusion and exclusion criteria. After extracting data and assessing the quality of the included studies, meta-analysis was conducted using Comprehensive Meta Analysis 3.0 software. Results A total of 12 studies involving 397 patients were included. BIS was positively correlated with RASS score and SAS, and the summary correlation coefficient was 0.742 with 95% CI 0.678 to 0.795 and 0.605 with 95% CI 0.517 to 0.681, respectively. Conclusion BIS has a good correlation with RASS and SAS, which will provide more options for assessing sedation of patients with mechanical ventilation in ICU.

Citation： WANG Zhuheng, CHEN Han, ZHOU Jianxin. Correlation between bispectral index monitor and subjective scale in assessing the depth of sedation of mechanically ventilated patients: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2017, 17(5): 544-549. doi: 10.7507/1672-2531.201609013 Copy

1.	?Barr J, Fraser GL, Puntillo K, et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med, 2013, 41(1): 263-306.
2.	Sharma A, Singh PM, Trikha A, et al. Entropy correlates with Richmond Agitation Sedation Scale in mechanically ventilated critically ill patients. J Clin Monit Comput, 2014, 28(2): 193-201.
3.	LeBlanc JM, Dasta JF and Kane-Gill SL. Role of the bispectral index in sedation monitoring in the ICU. Ann Pharmacother, 2006, 40(3): 490-500.
4.	Weatherburn C, Endacott R, Tynan P, et al. The impact of bispectral index monitoring on sedation administration in mechanically ventilated patients. Anaesth Intensive Care, 2007, 35(2): 204-208.
5.	Johansen JW. Update on bispectral index monitoring. Best Pract Res Clin Anaesthesiol, 2006, 20(1): 81-99.
6.	von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med, 2007, 4(10): e296.
7.	Sanderson S, Tatt ID and Higgins JP. Tools for assessing quality and susceptibility to bias in observational studies in epidemiology: a systematic review and annotated bibliography. Int J Epidemiol, 2007, 36(3): 666-676.
8.	李劍龍, 陳方堯, 李丹玲, 等. 具有相關關系的靈敏度和特異度的 Monte Carlo 模擬方法研究. 中國衛生統計, 2015, 32(3): 417-420.
9.	Simmons LE, Riker RR, Prato BS, et al. Assessing sedation during intensive care unit mechanical ventilation with the Bispectral Index and the Sedation-Agitation Scale. Crit Care Med, 1999, 27(8): 1499-1504.
10.	Riker RR, Fraser GL, Simmons LE, et al. Validating the Sedation-Agitation Scale with the Bispectral Index and Visual Analog Scale in adult ICU patients after cardiac surgery. Intensive Care Med, 2001, 27(5): 853-858.
11.	Deogaonkar A, Gupta R, DeGeorgia M, et al. Bispectral Index monitoring correlates with sedation scales in brain-injured patients. Crit Care Med, 2004, 32(12): 2403-2406.
12.	Arbour R, Waterhouse J, Seckel MA, et al. Correlation between the Sedation-Agitation Scale and the Bispectral Index in ventilated patients in the intensive care unit. Heart Lung, 2009, 38(4): 336-345.
13.	Karamchandani K, Rewari V, Trikha A, et al. Bispectral index correlates well with Richmond agitation sedation scale in mechanically ventilated critically ill patients. J Anesth, 2010, 24(3): 394-398.
14.	Yaman F, Ozcan N, Ozcan A, et al. Assessment of correlation between Bispectral Index monitorization and sedation scales used in the intensive care unit. Crit Care, 2010, 14(Suppl 1): 489.
15.	Prottengeier J, Moritz A, Heinrich S, et al. Sedation assessment in a mobile intensive care unit: a prospective pilot-study on the relation of clinical sedation scales and the bispectral index. Crit Care, 2014, 18(6): 543.
16.	林麗麗, 陳仲清. BIS 對外科危重患者鎮靜深度的監測作用. 廣東醫學, 2009, 30(7): 1138-1140.
17.	張川, 李孝錦, 李曉玉, 等. BIS 監測在機械通氣患者鎮靜深度評價中的價值. 華西醫學, 2008, 23(1): 41-42.
18.	李孝錦, 康焰, 張川. 腦電雙頻指數監測對機械通氣患者鎮靜深度評估的研究. 中國危重病急救醫學, 2009, 21(6): 361-363.
19.	顧勤, 劉寧, 葛敏, 等. 腦電雙頻指數監測在重癥加強治療病房機械通氣患者鎮靜中的應用. 中國危重病急救醫學, 2007, 19(2): 101-103.
20.	馬朋林, 趙金柱, 蘇瑾文, 等. 腦電雙頻指數與鎮靜一躁動評分評價機械通氣患者鎮靜程度可靠性的比較研究. 中國危重病急救醫學, 2006, 18(6): 323-326.
21.	Chisholm CJ, Zurica J, Mironov D, et al. Comparison of Electrophysiologic Monitors With Clinical Assessment of Level of Sedation. Mayo Clin Proc, 2006, 81(1): 46-52.
22.	Tasaka CL, Duby JJ, Pandya K, et al. Inadequate Sedation During Therapeutic Paralysis: Use of Bispectral Index in Critically Ill Patients. Drugs Real World Outcomes, 2016, 3(2): 201-208.
23.	Dale CR, Kannas DA, Fan VS, et al. Improved analgesia, sedation, and delirium protocol associated with decreased duration of delirium and mechanical ventilation. Ann Am Thorac Soc, 2014, 11(3): 367-374.
24.	Chong ID, Sandefur BJ, Rimmelin DE, et al. Long-acting neuromuscular paralysis without concurrent sedation in emergency care. Am J Emerg Med, 2014, 32(5): 452-456.
25.	Weir S and O’Neill A. Experiences of intensive care nurses assessing sedation/agitation in critically ill patients. Nurs Crit Care, 2008, 13(4): 185-194.

1. ?Barr J, Fraser GL, Puntillo K, et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med, 2013, 41(1): 263-306.
2. Sharma A, Singh PM, Trikha A, et al. Entropy correlates with Richmond Agitation Sedation Scale in mechanically ventilated critically ill patients. J Clin Monit Comput, 2014, 28(2): 193-201.
3. LeBlanc JM, Dasta JF and Kane-Gill SL. Role of the bispectral index in sedation monitoring in the ICU. Ann Pharmacother, 2006, 40(3): 490-500.
4. Weatherburn C, Endacott R, Tynan P, et al. The impact of bispectral index monitoring on sedation administration in mechanically ventilated patients. Anaesth Intensive Care, 2007, 35(2): 204-208.
5. Johansen JW. Update on bispectral index monitoring. Best Pract Res Clin Anaesthesiol, 2006, 20(1): 81-99.
6. von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med, 2007, 4(10): e296.
7. Sanderson S, Tatt ID and Higgins JP. Tools for assessing quality and susceptibility to bias in observational studies in epidemiology: a systematic review and annotated bibliography. Int J Epidemiol, 2007, 36(3): 666-676.
8. 李劍龍, 陳方堯, 李丹玲, 等. 具有相關關系的靈敏度和特異度的 Monte Carlo 模擬方法研究. 中國衛生統計, 2015, 32(3): 417-420.
9. Simmons LE, Riker RR, Prato BS, et al. Assessing sedation during intensive care unit mechanical ventilation with the Bispectral Index and the Sedation-Agitation Scale. Crit Care Med, 1999, 27(8): 1499-1504.
10. Riker RR, Fraser GL, Simmons LE, et al. Validating the Sedation-Agitation Scale with the Bispectral Index and Visual Analog Scale in adult ICU patients after cardiac surgery. Intensive Care Med, 2001, 27(5): 853-858.
11. Deogaonkar A, Gupta R, DeGeorgia M, et al. Bispectral Index monitoring correlates with sedation scales in brain-injured patients. Crit Care Med, 2004, 32(12): 2403-2406.
12. Arbour R, Waterhouse J, Seckel MA, et al. Correlation between the Sedation-Agitation Scale and the Bispectral Index in ventilated patients in the intensive care unit. Heart Lung, 2009, 38(4): 336-345.
13. Karamchandani K, Rewari V, Trikha A, et al. Bispectral index correlates well with Richmond agitation sedation scale in mechanically ventilated critically ill patients. J Anesth, 2010, 24(3): 394-398.
14. Yaman F, Ozcan N, Ozcan A, et al. Assessment of correlation between Bispectral Index monitorization and sedation scales used in the intensive care unit. Crit Care, 2010, 14(Suppl 1): 489.
15. Prottengeier J, Moritz A, Heinrich S, et al. Sedation assessment in a mobile intensive care unit: a prospective pilot-study on the relation of clinical sedation scales and the bispectral index. Crit Care, 2014, 18(6): 543.
16. 林麗麗, 陳仲清. BIS 對外科危重患者鎮靜深度的監測作用. 廣東醫學, 2009, 30(7): 1138-1140.
17. 張川, 李孝錦, 李曉玉, 等. BIS 監測在機械通氣患者鎮靜深度評價中的價值. 華西醫學, 2008, 23(1): 41-42.
18. 李孝錦, 康焰, 張川. 腦電雙頻指數監測對機械通氣患者鎮靜深度評估的研究. 中國危重病急救醫學, 2009, 21(6): 361-363.
19. 顧勤, 劉寧, 葛敏, 等. 腦電雙頻指數監測在重癥加強治療病房機械通氣患者鎮靜中的應用. 中國危重病急救醫學, 2007, 19(2): 101-103.
20. 馬朋林, 趙金柱, 蘇瑾文, 等. 腦電雙頻指數與鎮靜一躁動評分評價機械通氣患者鎮靜程度可靠性的比較研究. 中國危重病急救醫學, 2006, 18(6): 323-326.
21. Chisholm CJ, Zurica J, Mironov D, et al. Comparison of Electrophysiologic Monitors With Clinical Assessment of Level of Sedation. Mayo Clin Proc, 2006, 81(1): 46-52.
22. Tasaka CL, Duby JJ, Pandya K, et al. Inadequate Sedation During Therapeutic Paralysis: Use of Bispectral Index in Critically Ill Patients. Drugs Real World Outcomes, 2016, 3(2): 201-208.
23. Dale CR, Kannas DA, Fan VS, et al. Improved analgesia, sedation, and delirium protocol associated with decreased duration of delirium and mechanical ventilation. Ann Am Thorac Soc, 2014, 11(3): 367-374.
24. Chong ID, Sandefur BJ, Rimmelin DE, et al. Long-acting neuromuscular paralysis without concurrent sedation in emergency care. Am J Emerg Med, 2014, 32(5): 452-456.
25. Weir S and O’Neill A. Experiences of intensive care nurses assessing sedation/agitation in critically ill patients. Nurs Crit Care, 2008, 13(4): 185-194.

Chinese Journal of Evidence-Based Medicine

Correlation between bispectral index monitor and subjective scale in assessing the depth of sedation of mechanically ventilated patients: a meta-analysis

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